Thai newspaper: pandemic phase 4?

The Nation, a national newspaper in Thailand, is quoting Dr Kamnuan Ungchusak, the director of Thailand's Disease Control Department, Bureau of Epidemiology, as saying the bird flu virus has changed in a way as to alter the pandemic disease status from WHO's phase 3 ("Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact") to phase 4 ("Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans").

“It’s apparent to us insiders that [the virus] has already moved from phase 3 to phase 4 [in terms of the World Health Organisations’pandemic alert levels],” said Dr Kamnuan Ungchusak whose work on human-to-human H5N1 strain of avian flu was published in the New England Journal of Medicine in January.

Reports of the infection spreading among humans in four countries including Cambodia, Thailand, Indonesia and Vietnam have suggested to scientists that the virus has become more pathogenic than ever, the doctor said.

“The virus remains virulent enough to sicken or kill another victim who is in close contact with the infected person, said Kamnuan who is the director of the Disease Control Department’s Beureau of Epidemiology.

Reports of human-to-human infection have been most recently documented in a cluster of infections in Indonesia, he said, adding that all of the infected people were in the same family and had not been in contact with any poultry or other sources of disease, aside from infected family members.

Dr. Kamnuan is indeed a "flu insider," having reported the first widely accepted case of human to human transmission in the medical literature. The Nation records him as deploring his government's continued insistence that human to human transmission has not been demonstrated, characterizing it as "false information."

Thailand has been more diligent of late in surveillance and prompt reporting of poultry infections to the OIE (the international agency that keeps track of animal disease outbreaks). But they need to face the facts they report. Whether this is obfuscation to avoid alarming their citizenry or just plain denial is unclear, but Dr. Kamnuan is right on the mark here.

This virus is Hurricane Katrina a thousand times over.